Publications (6)3.22 Total impact

[Show abstract][Hide abstract]ABSTRACT: Objective: Orofacial pain is predominately mediated by the trigeminal system, and can produce somatosensory, gustative and olfactory abnormalities. The objectives of this study were to investigate the orofacial characteristics and sensory thresholds of 82 patients with orofacial pain and 41 controls.
Method: The methodology included gustative, olfactory, thermal (cold and warm), mechanical (vibration and tactile) and pain (deep and superficial) thresholds. The patients were also evaluated about their orofacial characteristics by a standardized evaluation which included the oral exam and muscular palpation. Data were tabled and statistically analyzed.
Result: The patients had lower gustative thresholds than the controls, except for fibromyalgia (P<0.001), and headache, pain intensity, numbness and dysesthesia were associated to loss of taste (P=0.028), abnormal taste (P=0.003), phantom taste (P<0.001) and burning mouth (P<0.001).
Conclusion:
In conclusion, gustative abnormalities can be associated to orofacial complaints and somatosensory findings in orofacial pain patients.

[Show abstract][Hide abstract]ABSTRACT: Objective: To evaluate the effect of prosthetic rehabilitation in oral function, cognition and nutritional status, in elderly edentulous patients.
Method: Thirty elderly (mean age 69.7±4.4 years old; 53.3% female) from a Dental Clinic of a private school of Dentistry were rehabilitated with total prosthesis; they were evaluated before (baseline - BS) and after the dental treatment (180 days - AT) according to their oral and mandibular characteristics. Temporomandibular disorders (TMD) were investigated using the Research Diagnostic Criteria for TMD and orofacial pain was assessed by a clinical protocol and the Visual Analogue Scale (VAS). Cognition and nutrition status were measured by the Mini Mental State Exam (MMSE) and the Mini Nutritional Assessment (MNA), respectively. Data were analyzed with the SPSS (v. 17) and the level of significance was 5%.
Result: At BS, 11 patients (36.7%) had orofacial pain complaints and 9 patients (30.0%) had at least three signs or symptoms of TMD. Mild cognitive impairment (15<MMSE<24) was found in 46.7% (n = 14) of patients and also 26.7% (n = 8) was classified as at risk of malnutrition (17<MNA<23.5). After 180 days, all patients attended the evaluation and there was a decrease in TMD symptoms (BS: 30.0%; AT: 10.0%; p=0.02), orofacial pain VAS score (BS: 1.4±3.2; AT: 0.37±1.4 p=0.02), MMSE scores (BS: 23.7±3.5; AT: 26.1±1.7; p<0.001) and MNA score (BS: 25.5±2.2; AT: 26.6±1.6; p<0.001).
Conclusion: The rehabilitation of the oral function with prosthesis improved the symptoms of TMD and cognitive and nutritional status. Functional mandibular aspects and dental prosthesis can play a role in the general health and can have a direct relation to nutrition, which has an important impact on the life of the elderly.

[Show abstract][Hide abstract]ABSTRACT: Voltage-gated sodium channels have been implicated in acute and chronic neuropathic pain. Among subtypes, Nav1.7 single mutations can cause congenital indifference to pain or chronic neuropathic pain syndromes, including paroxysmal ones. This channel is co-expressed with Nav1.8, which sustains the initial action potential; Nav1.3 is an embrionary channel which is expressed in neurons after injury, as in neuropathic conditions. Few studies are focused on the expression of these molecules in human tissues having chronic pain. Trigeminal neuralgia (TN) is an idiopathic paroxysmal pain treated with sodium channel blockers. The aim of this study was to investigate the expression of Nav1.3, Nav1.7 and Nav1.8 by RT-PCR in patients with TN, compared to controls. The gingival tissue was removed from the correspondent trigeminal area affected. We found that Nav1.7 was downregulated in TN (P=0.017) and Nav1.3 was upregulated in these patients (P=0.043). We propose a physiopathological mechanism for these findings. Besides vascular compression of TN, this disease might be also a channelopathy.

[Show abstract][Hide abstract]ABSTRACT: To investigate the clinical characteristics of patients with trigeminal neuralgia referred to surgery in a center of reference.
We evaluated the general characteristics of 395 patients with trigeminal neuralgia referred to neurosurgery as treatment. They corresponded to 2 samples of 1984 and 2004. The EDOF-HC protocol (Orofacial Pain Questionnaire) and the medical profile were used.
In the first study (1984), with 290 patients, the higher prevalence was: women (57.3%), white (95.5%), with mean age of 62.5. The most affected trigeminal branches were the maxillary and/or mandibular branches (65.5%), and the right side was the most affected (57.6%). From the second study (2004), with 105 patients, 57.1% were women, 75.2% white, with a mean age of 60.8. The maxillary and/or mandibular branches (79.0%) and the right side (69.5%) were the most affected. Both samples had neurological abnormalities and systemic diseases (mainly cardiovascular).
General characteristics of these patients were similar to other samples of trigeminal neuralgia. Neurological findings were also present in patients with no previous surgical treatment for TN. Hypertension and cardiac diseases were also frequent and make the monitoring of the patients during crises necessary.